Diagnostics of “non-acute” vascular prosthesis infection using 18F-FDG PET/CT: our experience with 96 prostheses

Špaček, Miroslav; Bělohlávek, Otakar; Votrubová, Jana; Sebesta, P; Štádler, P

doi:10.1007/s00259-008-1002-z

Cited by 141 publications

(107 citation statements)

References 29 publications

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“…In the absence of recent manipulations, 1,[33][34][35] Several studies have reported that PET/CT is useful for the diagnosis of intra-abdominal VGI. 1,[28][29][30][31][32][42][43][44][45][46] Three recent studies summarized the role of PET/CT for the diagnosis of VGI. [30][31][32] Although there were variables in imaging techniques and patient selection among these studies and other studies, the sensitivity and specificity of PET/CT were similar to those reported with standard CT for the diagnosis of VGI [28][29][30][31][32]39,[43][44][45][46] (Table 1 1 ).…”

Section: Intra-abdominal Vgimentioning

confidence: 99%

“…32 PET/CT alone or in combination with other imaging modalities can be considered if the results of standard CT studies are inconclusive for the diagnosis of VGI. [28][29][30][31][32][43][44][45][46] On the basis of the published studies, it is reasonable to use standard CT as the initial imaging modality for the diagnosis of VGI. [30][31][32] Intrathoracic VGI Imaging studies are necessary to confirm the diagnosis and define the extent of infection and vascular anatomy.…”

Section: Intra-abdominal Vgimentioning

confidence: 99%

“…[28][29][30][31][32][43][44][45][46] On the basis of the published studies, it is reasonable to use standard CT as the initial imaging modality for the diagnosis of VGI.…”

mentioning

confidence: 99%

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Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: A Scientific Statement From the American Heart Association

Wilson¹,

Bower²,

Creager³

et al. 2016

Circulation

373

307

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The use of synthetic material for reconstructive vascular surgery was first reported during the early 1950s. Infection involving vascular graft prostheses is an infrequent but devastating complication of reconstructive vascular graft surgery and is associated with a high morbidity and, in some situations, mortality. Improvements in surgical techniques and graft design, including the use of native venous or arterial tissue, have reduced the frequency of infection and severity of complications from vascular graft infection (VGI). However, these advances have also led to more frequent vascular graft procedures occurring in a patient population with multiple underlying comorbidities that would have previously disqualified them as candidates for vascular reconstructive surgery. Underlying comorbidities, such as diabetes mellitus or immune compromise, increase the risk of infection and serious infection-related complications. The major complications of VGI include sepsis, amputation, disruption of infected anastomotic suture line with rupture or pseudoaneurysm formation, embolization of infected thrombi, reinfection of reconstructed vascular grafts, enteric fistulae to the small or large bowel, bacteremic spread of infection to other sites, and death. VGIs can be categorized broadly into those that occur in an extracavitary location, primarily in the groin or lower extremities, or in an intracavitary location, primarily within the abdomen or less commonly within the thorax. frequencyThe frequency of VGI depends on the anatomic location of the graft. The infection rate is 1.5% to 2% for most extracavitary grafts and as high as 6% with vascular grafts in the groin. [1][2][3][4][5][6][7][8][9] For intracavitary grafts, the infection rate is ≈1% to 5%. 1-6 Graft infection is most common after emergency procedures and after reoperation. [1][2][3][4]10 Aortic graft erosion or fistulous communication into the duodenum or other areas of the bowel reportedly occurs in 1% to 2% of patients after aortic reconstruction. 11,12 MicrobiologyThe microbiological cause of VGI has evolved over the years. 1 In early published studies, Staphylococcus aureus was the predominant microorganism recovered. 1,13 Improvements in surgical technique, administration of prophylactic antistaphylococcal antimicrobial therapy, and other factors have resulted in a changing microbiological epidemiology. Vascular graft surgery performed on patients with multiple underlying comorbidities and the increased frequency of emergency procedures have contributed to the changing spectrum of infection. Other factors such as changes in hospital flora, surgery in patients with complicated vascular anatomy, and multiple revisions of previous vascular surgery have resulted in a more diverse microbio- clInIcal stateMents anD GuIDelInes logical spectrum of infection, which includes multidrugresistant strains, polymicrobial infection, and Candida species. Gram-positive cocci accounts for at least two thirds of VGIs. 1,13 Infections caused by coagulase-negative staphylococ...

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Section: Intra-abdominal Vgimentioning

confidence: 99%

Section: Intra-abdominal Vgimentioning

confidence: 99%

See 1 more Smart Citation

Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: A Scientific Statement From the American Heart Association

Wilson¹,

Bower²,

Creager³

et al. 2016

Circulation

373

307

View full text Add to dashboard Cite

show abstract

“…Кроме того, визуализирующие методы позво-ляют диагностировать развитие наиболее грозного ослож-нения течения инфекционного процесса -нарушение герметичности анастомоза с формированием ложной аневризмы и аррозивного кровотечения. В некоторых случаях, когда стандартные методы диагностики не по-зволяли однозначно судить о наличии или отсутствии ин-фекционного процесса в области СП, проводили пози-тронно-эмиссионную томографию (ПЭТ) с меченной фтором-18 фтор-2-дезокси-D-глюкозой (ФДГ) [13][14][15]. В ряде исследований было показано, что радиофармпре-парат ФДГ активно накапливается в тканях с высокой ме-таболической активностью, в том числе в воспалительном и инфекционном очагах [16].…”

Section: материал и методыunclassified

The choice of vascular prosthesis in high-risk aortic surgery

Andreychuk¹

2016

Kardiol. serdechno-sosud. khir.

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nikiforov all-Russian emergency and radiation medicine, Ministry of emergency situations, St. Petersburg, Russia the retrospective comparative analysis of prosthetic graft infection rate was done in two comparable groups. 267 high-risk patients underwent aortoiliac vascular procedures with implantation of silver-coated (Silvergraft, B.BRAun, germany) (main group, n=113) or simple dacron grafts (control group, n=154) in a single center. 22 cases of graft infection occurred (8.2%) 17 (77.3%) of which were registered in control group. Significant difference (p=0.0192) in infection rate between study groups had been revealed as early as one month and has been at the high by eight months. 45.5% of patients (all of them from control group) died due to infectious complications (sepsis, arrosive hemorrhage, endocarditis, multiorgan dysfunction) in 3-69 months' follow-up period. In conclusion, silver-coated grafts have a benefit in prevention of early and late infectious complication and prosthetic aortoiliac graft infection by high-risk patients.

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“…По мнению других авторов, ин-формативность КТ при ПИ не высока [16,18]. При обследовании 33 пациентов с подозрением на ПИ ФДГ-ПЭТ показала высокую чувствительность метода (91 %) [19,20], при этом прогностическая ценность достигла 95 % [21][22][23][24][25].…”

Section: таблиц аunclassified

Infection of vascular grafts

Абдулгасанов¹

2016

Kompleks. probl. serdečno-sosud. zabol.

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Федеральное государственное бюджетное учреждение «Научный центр сердечно-сосудистой хирургии им. А. Н. Бакулева» Российской академии наук, Москва, РоссияОписаны различные варианты хирургической тактики при протезной инфекции (ПИ) сосудов. Приведены основные виды хирургической тактики, такие как: экстраанатомическое шунтирование, использование искусственных протезов, применение ал-лографтов и бедренной вены. Указаны достоинства и недостатки каждого метода. Проведен сравнительный анализ используемых методик. Определены показания и противопоказания для каждого способа. Описаны ситуации, в которых возможно предпринять попытку консервативного ведения ПИ, а также применения искусственных протезов для репротезирования. Подробно изложены возможные пути предотвращения ПИ. Описаны различные подходы к антибиотикопрофилактике нагноений сосудистых протезов. Приведено поэтапное развитие методов профилактики инфекционных осложнений со стороны искусственного протеза.Ключевые слова: искусственный протез, инфекция протеза, экстраанатомическое шунтирование, аллографт. INFECTION OF VASCULAR GRAFTS R. A. ABDULGASANOV Federal State Budgetary Institution Bakoulev Scientific Centre for Cardiovascular SurgeryRussian Academy of Sciences, Moscow, Russia different variants of surgical tactics at suppuration of the vascular prosthesis are described in the review. Basic variants of surgical tactics such as extraanatomic bypass, vascular prosthesis regrafting, appliance of allograft and femoral vein are proposed. Pros and cons of each method are shown. Comparative analysis of the performed techniques was performed. Indications and contraindications for each method are determined. Situations suitable for attempt of conservative treatment of infected prosthesis and regrafting by vascular prosthesis are described. Possible ways of prevention of the vascular prosthesis contamination are described in details. different approaches to the antibiotics prevention of the infectious complications are listed.Step-by-step development of the prevention methods of the infectious complications is carried out.Key words: artificial prosthesis, prosthesis infection, extraanatomic bypass, allograft.Введение Инфекция сосудистого протеза -одно из самых грозных осложнений в сосудистой хирургии. По-сле реконструкции аорты, артерий у 1-6 % боль-ных наблюдается протезная инфекция (ПИ) [1][2]. ПИ артериальных протезов встречается у 4 % боль-ных, аорты 1-3 %, сопровождается потерей конеч-ностей и высокой летальностью (более 20 %) [3][4][5][6]. Актуальность проблемы подтверждает тот факт, что, например, в Швейцарии на лечение одного па-циента с ПИ тратится 72 350 франков [1]. Этиология, факторы риска и патогенезОсновными факторами риска развития ПИ яв-ляются пожилой возраст, ожирение, сердечная, почечная недостаточности, снижение иммуните-та, сахарный диабет, хроническая обструктивная болезнь легких, трофические язвы конечностей, длительное предоперационное пребывание в ста-ционаре, прием кортикостероидов, химиотерапия и др. [7][8][9]. Хирургические факторы риска включа-...

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Diagnostics of “non-acute” vascular prosthesis infection using 18F-FDG PET/CT: our experience with 96 prostheses

Abstract: PET/CT gave reliable results with an accuracy >95% in 75% of prostheses. PET/CT can identify those prostheses (25% of prosthesis) for which its diagnostic accuracy is diminished to 70-75%. In our series PET/CT was an excellent diagnostic modality for suspected VPI.

Cited by 141 publications

References 29 publications

Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: A Scientific Statement From the American Heart Association

Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: A Scientific Statement From the American Heart Association

The choice of vascular prosthesis in high-risk aortic surgery

Infection of vascular grafts

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